Bernstein Medical - Center for Hair Restoration - Bernstein Medical
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UV air purification systemUV air purification system

In order to protect our patients, doctors and staff, we have installed a UV purification system to reduce potential exposure to COVID-19.

This advanced technology uses the energy from a specially designed, high-intensity UV-C lamp to reduce microorganisms in the entire office as they cycle through the HVAC system.

The UV lamp mounted inside the air duct neutralizes a microorganism’s DNA and stops it from replicating. The UV system sterilizes or kills most contaminants as they pass by the lamp. It is especially effective in destroying viruses.

Here are additional benefits of our air filtration system:

  • Removes contaminants from air duct
  • Reduces spore count
  • Helps to eliminate bacteria and viruses
  • Optimize energy-efficiency
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Hims Logo

On our Facebook and Instagram feeds, billboards, on the side of buses, and lining the walls of the subway, are ads of young, attractive men with voluptuous locks and titles saying things like “Hair loss is optional” and “Handsome, healthy you.” These are the ads for the millennial men’s wellness brand, Hims. Hims, and fellow start-up Keeps, offer hair loss solutions (that would normally be prescribed in-person, by a doctor) in one simple package to your home.

Though it seems like Hims and Keeps are bringing new medicines to the table, their hair loss “kits” and hair loss “gummies,” are just the same hair loss products that you can receive from a doctor or from online stores like Amazon, such as minoxidil, finasteride, biotin, salicylic acid shampoos and other topical and oral medications. The medical patent on Propecia (finasteride) expired in 2014 allowing other drug companies to sell a generic version of Propecia under a different name. This enables companies like Hims and Keeps to market these drugs under their own brands, mix or add ingredients without proven efficacy, and present them as completely new solutions to hair loss.

A crucial part that is missing in this business model is the importance of a conversation between a board-certified physician and the patient. Both minoxidil and finasteride have important side effects that need to be discussed with a physician and should only be prescribed to those that would benefit from the medicine. In addition, there are ways in which the medications can be used that will add to their efficacy. Finally, there other options, such as hair transplantation that might be appropriate to consider at some point.

This relationship between a patient and doctor is an invaluable part of the hair loss treatment process, and one that you will not receive through online medical treatments. If you would like more information about the diagnosis and treatment of hair loss, an excellent resource is www.bernsteinmedical.com.

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Dr. Robert M. Bernstein

Dr. Bernstein was recently a guest on “The Beauty Doc” podcast with a master of oculoplastic & facial plastic surgery, Dr. Joel E. Kopelman.

Here, they discussed causes of hair loss in both men and women, the difference between hair falling out and balding, both the mental and physical effects of hair loss, when to come in for a consult and medical and surgical treatments for hair loss.

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Q: As a medical advisor and an end-user of the ARTAS Robotic System, do you see any impact of your involvement with Restoration Robotics? — J.V. ~ Miami, F.L.

A: Restoration Robotics has been very responsive to the needs of its physicians and to their patients. Because I work closely with Restoration Roboticsin the development of new improvement and advances they are often introduced first in our practice.

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Accreditation Association for Ambulatory Health Care (AAAHC)Bernstein Medical – Center for Hair Restoration is pleased to announce that we have, once again, been certified by the Accreditation Association for Ambulatory Health Care (AAAHC).

The three-year accreditation is granted to medical centers that demonstrate high standards in delivering patient care, expert record keeping, the most rigorous safety protocols, as well as a commitment to developing new ways to provide optimum service to our patients.

The certificate states that the accreditation is in recognition of our:

Commitment to high quality of care and substantial compliance with the Accreditation Association for Ambulatory Health Care standards for office-based surgical practices.

Accreditation remains an important aspect in the continued growth and success of our state-of-the-art hair restoration practice. This designation from the AAAHC signifies that Bernstein Medical – Center for Hair Restoration has met the rigorous standards of a nationally recognized third party.

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After years of jokes about his continually receding hairline, LeBron James, basketball superstar and winner of two NBA championships and four NBA Most Valuable Player Awards, stunned the sports world on September 16th, 2014 when he revealed a newly restored hairline while promoting his new LeBron 12 shoe at Nike World Headquarters.

FUE Hair Transplant Most Likely Responsible for LeBron James’ New Hairline

Folks are now asking – where, when and how did LeBron get that great new hairline?

While no one knows for sure (and LeBron, so far, hasn’t said a word), Katie Nolan, the host of FoxSports.com’s No Filter, rejects the idea that LeBron’s new life in Cleveland is less stressful than it was in Miami and that’s what allowed his hairline to return. Instead, she strongly suspects that it is the result of an advanced surgical hair restoration technique called Follicular Unit Extraction, or FUE, which produces hair transplant outcomes that look completely natural.

She also suspects the use of low-level laser therapy (LLLT) which new research has shown to be an effective treatment for male and female pattern hair loss.

Katie Nolan breaks it all down for you in her No Filter segment below, “LeBron James unveils his new hair (and some shoes).”

Read about FUE Hair Transplants

View Before & After Photos of some of our hair transplant patients

Visit Bernstein Medical for a one-on-one hair loss consultation with one of our board certified physicians

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Innovative Bernstein Medical Awarded As Best New York Small Business To Work ForBernstein Medical Wins 2013 ‘Best Companies to Work For in New York’ Award. Sandra Medina (2nd from left) an Employee for 18 years, accepts award.

Dr. Bernstein has received plaudits for his innovation and leadership in hair transplantation and medical hair restoration. However, what is less frequently noted is that he holds an MBA from Columbia University and has applied some of this knowledge toward making his company a leader in the business community as well.

Now, Bernstein Medical – Center for Hair Restoration is receiving its own recognition for leadership in appreciating the value of its workers. The Society for Human Resource Management (SHRM) has named Bernstein Medical the number one small or medium-sized business to work for in the state. The 2013 ‘Best Companies to Work For in New York’ list placed Bernstein Medical at the top slot, out-ranking companies from New York City as well as Rochester, Syracuse, and elsewhere in the state.

Bernstein Medical was also featured in the 2013 awards program:

“A recognized leader in the development of hair transplantation techniques and clinical research, the center was the third in the world and one of 12 current hair restoration practices to utilize and control the ARTAS Robot in follicular unit extraction procedures. Seminars, meetings and continuing education classes help the physicians, surgical team and front-office staff to maintain a high degree of ethics, innovation and the latest skills.

The long-term, family-forward attitude of the workplace is supported by a retirement plan and package that couples a 401(k) with both safe harbor and profit-sharing benefits. […] A team culture allows those who work there to voice their ideas and opinions with confidence.”

Created in 2007, these celebrated annual awards are a distinctive program that evaluates and ranks the best places of employment based on employee satisfaction and engagement, as well as workplace practices and policies. The assessment is made using a two-part survey process. In the first part, the employer provides details about company benefits, policies, and practices. The second, and most important, part is a confidential employee survey in which employees evaluate their workplace experience.

The program is a partnership of New York State SHRM, Best Companies Group, Journal Multimedia Corporation and The Business Council of New York.

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Accreditation Association for Ambulatory Health Care (AAAHC/Accreditation Association)Bernstein Medical – Center for Hair Restoration has received a three-year re-certification for accreditation by the Accreditation Association for Ambulatory Health Care (AAAHC/Accreditation Association).

The accreditation process demands proof of a high level of commitment to rigorous standards in patient care, quality improvement, record keeping, patient and staff safety and security, as well as a desire and responsibility to continually upgrade and investigate new ways to provide optimum service to our patients. Accreditation is an important aspect in the continuing growth and success of our health care practice.

Accreditation is proof of this commitment, and signifies that Bernstein Medical – Center for Hair Restoration has met the rigorous standards of a nationally recognized third party.

Read about Accreditation by the AAAHC

Read about our NYC hair restoration center

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Best Companies to Work for in NYS 2013Bernstein Medical – Center for Hair Restoration has been named as one of the best companies to work for in New York.

Best Companies Group, an independent survey firm, evaluates the best places of employment in each State based on workplace practices, environment and employee satisfaction. Bernstein Medical will be honored at a public awards dinner to be held the Albany Marriott on Tuesday, April 30, 2013.

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WABC-TV Eyewitness News; channel 7 in New York, NY; featured Dr. Bernstein in a special report on hair loss and hair loss medications. In particular, the report, by ABC correspondent Kemberly Richardson, asked Dr. Bernstein about the effectiveness of Propecia/Finasteride and Rogaine/Minoxidil in the treatment of male pattern hair loss.

The report also featured the new Consumer Reports consumer survey on the same hair loss treatments. Consumer Reports Health & Family Senior Project Editor Tod Marks details how the more than 8,000 consumers who took part in the survey rated the performance of the medications.

Watch the report:

For more on the news report, visit Coping With Hair Loss at ABC News.

For more on the Consumer Reports survey, visit Baldness remedies at Consumer Reports Health. Note: a subscription to ConsumerReportsHealth.org is necessary to view the complete findings of the survey.

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by J. F. Fotrell

Celebrities – especially the men – are getting comfortable with the idea of surgical hair restoration and we are seeing more famous men embracing the concept every day. The truth is that the majority of men will eventually lose hair, so this is nothing to be embarrassed about. But most men don’t have to depend on their appearance to pay their mortgage bill, or to ensure that their career continues. Celebrities find themselves in a unique position in this respect, especially when the world is watching them grow up or grow old.

Celebrity Hair Transplants - Kevin Costner

Celebrity hair loss is becoming an increasingly hot topic in the media. The continuing demands on celebrities to keep their good looks, seems to be of great interest to the tabloids. This is evidenced by the recent interest in the hairlines of stars like John Cleese, Mel Gibson, John Travolta, Kevin Costner, Dennis Miller, Tom Arnold, Johnny Depp, Jude Law, David Beckham and many others.

For example, a Google search for “Mel Gibson hair loss” has almost 50,000 entries. This attests to the amount of attention the media – and the public – are paying to celebrity hair restoration.

Many celebrities don’t mind their hair loss when it comes to their own personal life, but they realize that appearance is paramount in the entertainment industry. Celebs worry that their looks are important to the fans, and they seem to be right.

Celebrity Hair Transplants - Mel Gibson

Chat rooms and fan sites are abuzz with the hair lines of the stars, not to mention the TV, magazines and newspapers which seem to always know when to get a picture at the right (or the wrong) time.

Often celebrities have hair transplant surgery only to satisfy the demands of their careers. Soap Opera stars for instance, need those wonderfully youthful hairlines, something that would not be in such demand with the general aging public. The hair transplant design required by someone in this profession, however, might not be appropriate for the average person.

Celebrity Hair Transplants - John Travolta

As a result, actors sometimes need to make some compromises on long-term results in order to achieve short-term career goals.

In order to create the illusion that time has simply stood still for people in the public eye, secrecy is paramount. Cosmetic surgeons for the stars are very meticulous about maintaining privacy, and understanding the special needs of their celebrity patients.

“Though the public tends to perceive celebrities as temperamental and demanding, I have not found that to be the case. Celebrities recognize the importance of cosmetic surgery to their careers and are very pragmatic about having it done – for most it simply goes with their job.” says Robert M. Bernstein M.D., Clinical Professor of Dermatology at Columbia University in New York and founder of Bernstein Medical – Center for Hair Restoration in Manhattan.

Interest in celebrity hair transplants is not just reserved for film and TV stars, but for all kinds of professions in the public eye. Sports celebrities like Tom Brady, politicians, fashion designers, musicians, and now even top business executives recognize the importance of hair to their image.

Celebrity Hair Transplants - David Beckham

Busy celebrities often have their PR people or handlers try to discover what their treatment options may be, but often the proper research is not done. After all, PR people are influenced by the media just like the rest of us. The far better route is the more time consuming one, where academic credentials and hospital affiliations are checked and medical publications are reviewed. Without this level of research, the search for a hair transplant surgeon can lead to some pretty bad results.

According to Dr. Robert Bernstein of the Bernstein Medical – Center for Hair Restoration in Manhattan, “Most Celebrities aren’t as concerned with how the process is done; they simply want it to be taken care of. One high profile patient of ours, however, was so curious about the process, that he actually left the surgical chair during his procedure so that he could watch how the graft dissection was done.”

In this very competitive society, youth and beauty are highly coveted bargaining chips.

Celebrity Hair Transplants - Matt Lauer

One without the other can seem to be a considerable handicap. However, in the world of the rich and famous, where ones livelihood depends on physical image the stakes are even higher.

Fortunately, with modern medical breakthroughs, the image that is conveyed by a full, healthy head of hair is something that can be achieved, even by people who are not so genetically fortunate.

View before & after hair transplant photos of our patients

Read about hair transplant procedures

Read about medical hair restoration

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Q: Is using Minoxidil combined with Retin-A better than regular Minoxidil for Hair Loss? — L.W., Gowanus, New York

A: Minoxidil has been prescribed (off-label) in combination with other medications, such as topical retinoic acid (Retin-A), to enhance its penetration into the skin and thus increase its effectiveness. This combination of medications can increase the absorption of minoxidil into the bloodstream and may increase the risk of potential side effects, including changes in blood pressure and scalp irritation. It is important to use combination therapy under the supervision of a physician.

If person wants to add Retin-A to the minoxidil regime, the Retin-A should be applied only once a day, since the Retin-A will bind to the skin and will last for at least 24 hours.

Applying Retin-A more frequently will not increase its effectiveness (in facilitating the absorption of minoxidil); it will only increase the incidence of side effects. Retin-A can be applied to the scalp at the same time as Minoxidil, or by itself.

Explore the pro’s and con’s of Minoxidil — also known by its over-the-counter product Rogaine — at the Rogaine/Minoxidil page or by viewing posts tagged with Rogaine (minoxidil).

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Q: I would like to have the donor area from an old hair transplant repaired so it does not show the scar when I cut my hair shorter. What are my options?

A: Widened scars can be improved in two ways: they can be re-excised to make the scar finer, or hair can be placed into the scar to make it less visible.

Excising a scar works best when the original incision was closed with poor surgical techniques. In this case, using better closure methods can improve the scar. When the scar is the result of a person being a naturally “poor healer,” a wide scar will be the result – regardless of how the incision was closed.

I often approach the problem by excising a small area first, to see if I can decrease the width of the scar. If so, I would then proceed to excise the rest of the scar. If not, I would obtain hair using follicular unit extraction (FUE) — extracting hair in follicular units directly form the scalp — and place this hair into the scar. The hair placed in the scar can also be obtained from the edges of a partially excised scar.

If a wide scar that is thickened (called a hypertrophic scar) is also excised, it will usually reoccur and may result in an even worse scar. Because of this, thick scars should be flattened with injections of cortisone prior to removing. This will decrease the chance of a recurrence.

Flattening the scar is also important to permit the growth of newly transplanted follicular unit grafts.

For more on this topic, please see the page on Fixing Scars.

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Patient JAZ before and after hair transplant photo

Bernstein Medical patient before (left) and after (right) hair transplant

We all know that hair loss is common among both men and women, and that hair transplant and hair restoration procedures are becoming more and more popular around the world. But what thoughts go through the head of your average hair loss sufferer before, during, and after a hair transplant?

The answer to that question may now be revealed. ABC News correspondent Cari Nierenberg and associate producer Ryan Stevenson take us directly into the mind and life of Bernstein Medical patient Adam Khoudja in a diary and feature on hair loss and hair restoration.

View each article at ABCNews.com:

You can also see the patient’s full before/after photoset in our Hair Transplant Photos gallery

Learn more about the hair transplant procedure and visit our own hair transplant photo journal.

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Q: Why did you write another book on hair loss? — K.L., Greenville NY

A: Hair Loss and Replacement for Dummies is the first book that we have written that is specifically geared for the lay public. Besides hair restoration, it covers a wide range of topics including: the diagnosis and treatment of medical conditions that can cause hair loss, tips on hair care, information on hair systems, and a number of other topics not stressed in our other books.

Our prior books, The Patient’s Guide to Hair Restoration and The Guide to Hair Restoration focused on medical treatments and surgical hair restoration. Although very easy to understand, they are most helpful for someone that already has a basic understanding of hair loss or that had a consultation.

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Dr. Bernstein, pioneer of Follicular Unit Hair Transplantation, was a featured guest on The Oprah Winfrey Show. In addition to discussing his hair transplant technique, Dr. Bernstein showed Oprah and Dr. Mehmet Oz the results of a hair transplant on one of his patients. They also showed a video montage of Dr. Bernstein performing a hair restoration procedure.

Please read the full Bernstein Medical – Center for Hair Restoration press release below:

New York, NY (PRWEB) October 7, 2008 – The Oprah Winfrey Show features Dr. Bernstein discussing his pioneering follicular unit hair transplant procedure, focusing on the newest diagnostic and treatment techniques for hair restoration. The Oprah Winfrey Show aired Tuesday, October 7th at 4:00PM EST on ABC.

Dr. Bernstein is a Clinical Professor of Dermatology at the College of Physicians and Surgeons of Columbia University in New York. He is recognized world-wide for his pioneering work in the treatment of hair loss. Dr. Bernstein is known for developing the revolutionary Follicular Unit Transplantation procedure for hair restoration.

Dr. Bernstein with Dr. Oz and a Patient on the Oprah Winfrey ShowDr. Bernstein with Dr. Oz and a Patient on the Oprah Winfrey Show

After introducing Dr. Bernstein to Oprah, Dr. Mehmet Oz (health expert on The Oprah Winfrey Show) presents video footage of Dr. Bernstein performing a hair transplant and then invites the patient live onstage to be inspected by Oprah. In addition to engaging with the audience about baldness and hair transplant procedures, Dr. Bernstein examines a person from the audience who is experiencing early hair loss using an instrument known as a densitometer.

The densitometer is a self-contained, portable, device that houses a magnifying lens for viewing hairs close to the scalp. The idea behind densitometry is to determine the degree of miniaturization, or shrinking of the hair’s diameter, which contributes to hair loss. This information is used to evaluate whether the patient is a good candidate for hair transplant or medical treatment, as well as to predict future hair loss.

“Follicular Unit Transplantation is a procedure where hair is transplanted exclusively in its naturally occurring groups of 1-4 hairs. It is the logical end point of over 30 years of evolution in hair transplantation surgery,” explained Dr. Bernstein. “However, this by no means implies our work is complete. We are obsessed with making the procedure as perfect as possible.”

View the original press release at PRWeb.

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Columbia University Medical CenterColumbia University Medical Center has awarded Dr. Bernstein, Clinical Professor of Dermatology, a “Certificate of Appreciation” for sustained contributions to the academic programs of the Department of Dermatology, Columbia University. Please read below for the Bernstein Medical – Center for Hair Restoration press release and a transcript of an interview with Dr. Bernstein on receiving the honor:

Press Release:

New York, NY (PRWEB) October 2, 2008 — Columbia University Medical Center awarded their Certificate of Appreciation to Robert M. Bernstein, MD, founder of Bernstein Medical – Center for Hair Restoration for his sustained contributions to the academic programs of the Department of Dermatology at Columbia University.

Dr. Bernstein specializes in hair loss and hair transplant surgery. He was instrumental in developing the Follicular Unit Hair Transplant procedure, now considered the most advanced technique for surgical hair restoration. This procedure has revolutionized modern hair transplantation, with its unique ability to mimic natural hair growth patterns in the scalp.

In the past, multiple, small procedures were an inefficient way to restore a person’s hair. Using these new techniques, we now have the ability to transplant 3000 or more follicular units safely in one session.

“With respect to medical feasibility, follicular hair transplant surgery is significantly different from traditional grafting,” notes Dr. Bernstein. “In the past, multiple, small procedures were an inefficient way to restore a person’s hair. Using these new techniques, we now have the ability to transplant 3000 or more follicular units safely in one session.”

The complex nature and microscopic scale of the Follicular Unit Hair Transplantation procedure require superior surgical precision. Dr. Bernstein is well known for his surgical skill and talent; he has been named in New York Magazine’s “Best Doctors” list 9 years in a row.

In addition to his world-renowned skill in the field of hair replacement surgery, Dr. Bernstein is also acclaimed for the care that he provides for his patients. Dr. Bernstein and the rest of the staff at the Bernstein Medical Center for Hair Restoration aim to provide their patients with the best possible care and comfort during their hair transplant procedure. Their award winning website www.bernsteinmedical.com is recognized for providing outstanding health information.

Columbia University is one of the world’s most important centers of medical research and distinguished learning environment for undergraduates and graduate students in many scholarly and professional fields. The University recognizes the importance of its location in New York City and seeks to link its research and teaching to the vast resources of a great metropolis. It seeks to attract a diverse and international faculty and student body, to support research and teaching on global issues, and to create academic relationships with many countries. It expects all areas of the university to advance knowledge and learning at the highest level and to convey the products of its efforts to the world.

About Dr. Bernstein:

Dr. Bernstein is the most widely published author on the subject of Follicular Unit Hair Transplantation, with over fifty articles, editorial reviews, books and textbook chapters. His landmark scientific papers are considered to be seminal works in the field of hair transplant surgery. In addition to a busy surgical practice, Robert M. Bernstein, MD, is Clinical Professor of Dermatology at Columbia University in New York. He lectures both nationally and internationally on the diagnosis and treatment of hair loss and treats patients from all over the globe at his state-of-the-art surgical facility in mid-town Manhattan.

Interview:

Interviewer: I am here today with Dr. Robert M. Bernstein, founder of the Bernstein Medical – Center for Hair Restoration. Dr. Bernstein is the recipient of the “Platinum Follicle Award” the highest honor given by the International Society of Hair Restoration Surgery. He has been chosen as one of New York Magazine’s “Best Doctors in New York” for nine consecutive years. Good morning Dr. Bernstein.

Dr. Bernstein: Good morning.

Interviewer: Dr. Bernstein, I understand you have recently been awarded a Certificate of Appreciation from Columbia University in New York.

Dr. Bernstein: Yes, I have been teaching at Columbia for 25 years. I was very honored to receive it.

Interviewer: Could you tell us about it?

Dr. Bernstein: The certificate is for the contributions that I have made to the academic programs of the Department of Dermatology.

Interviewer: You specialize in hair replacement and hair transplant surgery, and you were instrumental in developing the Follicular Unit Hair Transplantation procedure. Why don’t you tell us a little bit about this procedure and how you came up with the idea?

Dr. Bernstein: Sure. The Follicular Unit Hair Transplantation procedure is based on the discovery that in humans, hair does not grow singly as one commonly thinks, but rather, in tiny bundles of one to four hairs. We call these bundles follicular units. While evaluating patients for surgery using an instrument called a densitometer we could easily visualize these naturally occurring groups. It just made sense to perform the entire transplant using these tiny follicular units, as it would allow us to most closely mimic nature. We found that it also would enable us to safely transplant thousands of grafts in a single session and, for the patient, to complete the hair restoration as quickly as possible.

Interviewer: Interesting. I understand you not only use your knowledge in practice, but you are the most widely published author on this subject.

Dr. Bernstein: It is through publishing in medical and scientific journals that we can best share our ideas with our colleagues and ultimately improve patient care.

Interviewer: Is there a website where listeners can find these papers and learn more about the procedure and other information about hair loss?

Dr. Bernstein: Yes. If they go to the Bernstein Medical – Center for Hair Restoration website they will find links to all of my medical publications. The site has my blog and a lot of other useful information for persons who are experiencing hair loss.

Interviewer: Well, again congratulations, it was good to have you on the program.

Dr. Bernstein: Thank you.

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Q: Didn’t you do free consults in the past? — N.F., Bronxville, NY

A: Yes. It had been in response to the policy of the larger chains. Patients coming to our practice are evaluated by a board certified dermatologist, trained in diagnosing the causes of your hair loss with expertise in both medical and surgical management. Our consults are not just screens for surgery.

Read more information on becoming a new patient on the Bernstein Medical – Center for Hair Restoration website. If you are ready for a hair loss or hair transplant evaluation, click here to schedule an evaluation with the doctor.

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Q: I am female and thinning can I be a candidate for a Follicular Unit Hair Transplant?

A: If it turns out that you have female pattern hair loss, you may be a candidate a hair transplant, but would need to be evaluated by a doctor who specializes in surgical hair restoration.

In the evaluation, you should have your degree of hair loss assessed and donor supply measured, using an instrument called a densitometer, to be certain that you have enough permanent donor hair to meet your desired goals. For more information about hair loss in women, please see the Diagnosis of Hair Loss in Women page of the Bernstein Medical – Center for Hair Restoration website.

If you are thinking about your hair loss and would like to be evaluated, go to the physician consult page to schedule a consultation.

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Q: Can stress produce diffuse unpatterned hair loss (DUPA), or was it bound to happen anyway? — D.D., Park Slope, Brooklyn

A: Both DPA (diffuse patterned hair loss) and DUPA (diffuse unpatterned hair loss) are genetic conditions, unrelated to stress and would have happened anyway. These types of hair loss are characterized by a high percentage of mininiaturized hair in broad areas of the scalp. See the Classification of Hair Loss in Men and Classification of Hair Loss in Women pages on the Bernstein Medical – Center for Hair Restoration website for more information on this topic.

In contrast, stress generally presents as increased hair shedding, a reversible condition referred to as telogen effluvium. It is called this because the normal growing hair is shifted to a resting (telogen) phase before it temporarily falls out. Increased miniaturization is not associated with telogen effluvium.

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The website of Bernstein Medical – Center for Hair Restoration, a state-of-the-art hair transplant facility in Manhattan, was recently recognized by the World Wide Web Health Awards as one of the Internet’s best resources. BernsteinMedical.com was acknowledged for outstanding health information, based on accuracy, usability, and overall quality.

With over 30,000 unique visitors a month, the Center’s website has helped potential hair transplant patients from all over the world make educated decisions regarding their hair loss, including preventative medications and possible surgery.

“One of the most popular features of our website is the Hair Transplant Blog. It allows users to send in their questions and get clear, concise answers,” says Dr. Bernstein. “I try to clear up as much of the misinformation about hair restoration as I possibly can.”

Nearly two thirds of American males experience some measurable form of hair loss by age 35, according to the American Hair Loss Association. With millions of men and women seeking reliable information, Dr. Bernstein recognized the need for an informative, easy-to-navigate hair restoration resource on the Web.

The World Wide Web Health Awards is organized by the Health Information Resource Center (HIRC), a national clearinghouse for consumer health information programs and materials. These Web-based health awards are an extension of the HIRC’s 14-year old National Health Information Awards (NHIA), the largest program of its kind in the United States.

Bernstein Medical – Center for Hair Restoration, located in midtown Manhattan, is designed to deliver state-of-the-art hair transplant surgery. Dr. Bernstein is world renowned for his pioneering work in Follicular Unit Hair Transplantation and Follicular Unit Extraction. In addition to his private practice, Dr. Bernstein is Clinical Professor of Dermatology at Columbia University in New York.

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Q: I was looking at the hair transplant photos on the Bernstein Medical – Center for Hair Restoration website. I noticed that you and the NHI website have some of the same pictures. Did you both perform surgeries on these people? — B.B., Columbus Circle, N.Y.

A: All of the patients that appear on the Bernstein Medical website were operated on by me personally. My own staff assisted me in these procedures.

I worked with Dr. Rassman at NHI from 1995 to 2004. Photos of patients that I operated on during this period may therefore also appear on the NHI website.

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Densitometry - Hair Transplant Forum International - March/April 1997To give hair restoration surgeons more precise diagnostic information in their evaluation for patients considering hair transplants, Dr. Bernstein uses the techniques of densitometry and video-microscopy to analyze the scalp under high-powered magnification.

The technique gives important information on hair density, the composition of the patient’s follicular units and the diameter of their hair shafts. The new instruments give doctors vital information for making decisions about whether patients are candidates for hair transplant surgery, the amount of donor tissue needed for the hair restoration, and to help them better predict how the results of hair transplants will ultimately look.

For more information, please see Dr. Bernstein’s publication on densitometry, a podcast on hair transplantation that discusses densitometry, and the Bernstein Medical – Center for Hair Restoration press release on the news below:

Baldness Detection Devices Featured in Medical Journal

Hair Transplant Forum International publishes new article on hand-held instruments used in hair loss detection and planning for hair transplants.

The lead article in the March/April issue of the journal published by The International Society of Hair Restoration Surgery (ISHRS) focuses on the latest tools available for assessing whether or not a person experiencing hair loss is a good candidate for hair transplant surgery.

The cover story: “Densitometry and Video-microscopy” written by Robert M. Bernstein, M.D. and William R. Rassman, M.D. explores the often overlooked diagnostic practice of analyzing the scalp under high-power magnification. Getting an extreme close-up of hair patterns at the base of the scalp allows hair transplant surgeons and dermatologists a chance to not only screen candidates for appropriateness for surgery, but can also predict future hair loss patterns.

Dr. Bernstein, founder of the New York based Bernstein Medical – Center for Hair Restoration, is known for his pioneering work in new hair transplantation techniques. When asked why he thought the article was given so much prominence in the Hair Transplant Forum, he suggested that “these simple hand held instruments should be essential tools of the hair transplant doctor.” He cautioned that without precise measurements doctors run the risk of performing surgery on persons who may is not suited for this procedure.

Dr. Bernstein has authored over 50 papers on hair transplantation including some of the most influential research on techniques used to repair badly performed hair transplants. In his seminal publications describing Follicular Unit Transplantation (FUT), Dr. Bernstein introduced a brand new method of hair restoration surgery which recognized follicular units (groups of naturally growing hair follicles) as the ideal element of donor tissue to be used in hair transplants. FUT is now considered to be the state-of-the-art in surgical hair restoration.

Dr. Bernstein and his colleague Dr. Rassman began utilizing the Densitometer to determine specific hair characteristics such as hair density, and changes in hair diameter that are important in both determining who are potential surgical candidates for the new hair transplant procedures and who may respond to medications.

The International Society of Hair Restoration Surgery (ISHRS), a non-profit organization of over 700 hair restoration doctors, publishes Hair Transplant Forum to keep the Society abreast of the most recent developments in the field of hair transplantation.

Dr. Bernstein is known to the general public from his appearances on NBC’s Today Show with Matt Lauer, CBS’s The Early Show, ABC’s Good Morning America, The Discovery Channel and other nationally syndicated programs.

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Q: I had several prior hair transplants that left me with a pluggy look, I was hoping to re-utilize the removed hair and re-implant it, perhaps in the front as a new, more recessed hairline. It is possible?

A: The hair from the excised grafts is always re-implanted.

The grafts that are removed are dissected into individual follicular units and then placed back in the recipient area in a more natural distribution and angle. See Patient LKE’s before and after photos in the Hair Transplant Repair Photo Gallery.

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Q: I had an old hair transplant and I’m hoping to remove these plugs and of course am concerned how much additional scarring would result. I’m wondering if removal of the total hair plugs (which are perhaps 2 or 3 mm in diameter) by coring them out would result in a lot of additional scarring.

A: It will significantly reduce the scarring.

The reason is that the round disc of scar tissue at the bottom of the graft from prior plug hair transplants will be removed and the normal skin edges will be brought together resulting in a barely perceptible fine line scar.

See the Graft Excision in Hair Transplants page.

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Q: Some surgeons are doing hair transplants using 5,000 to 6,000 grafts in a single surgery. Looking at the cases in your photo gallery, it seems like your hair transplants involve many fewer grafts per surgery. Do you do such large graft numbers in a single hair restoration procedure? — H.P., Cranston, R.I.

A: The goal in surgical hair restoration should be to achieve the best results using the least amount of donor hair (the patient’s permanent reserves) and not simply to transplant the most grafts in one session. In my opinion, although large sessions are very desirable, the recent obsession with extremely large numbers of grafts in one session is misplaced. The focus should be on results.

For example, I would prefer to have full growth with a properly placed 2,500 – 3,000 graft hair transplant session than partial growth in a 5,000 graft session. Of course, the 5,000 graft session will look fuller than 2,500 grafts but, in my experience, never twice as full, and never as full as two 2,500 graft sessions.

The ability to perform large sessions is possible because of the very small recipient sites needed in Follicular Unit Transplantation (FUT). It is one of the main reasons that we developed this procedure in back in 1995. See the first paper on this subject: Follicular Transplantation.

However, like all good things, the technique loses some of its advantage when taken to extreme.

In “very” large sessions, the long duration of surgery, the increased time the grafts are outside the body, the increased amount of scalp wounding, risk of poor growth, wider donor scars, placing grafts where they are not needed, sub-dividing follicular units, and the decreased ability to plan for future hair loss, can all contribute to suboptimal results. These problems don’t always occur, but the larger the session, the greater the risk. Therefore, it is important to decide if one’s goal is simply to transplant the maximum amount of hair that is possible in one session, or to get the best long-term results from your hair restoration.

Follicular Unit Preservation

One of the most fundamental issues is that doctors using very large sessions are not always performing “Follicular Unit Transplantation” and, therefore, in these situations the patients will not achieve the full benefit of the FUT procedure. Although doctors who perform these very large sessions take the liberty of calling their surgery “Follicular Unit Transplantation,” in actuality it is not, since naturally occurring follicular units are not always kept whole. The procedure is defined as follows: “Follicular Unit Transplantation is a method of hair restoration surgery where hair is transplanted exclusively in its naturally occurring, individual follicular units.” (see Hair Transplant Classification)

By preserving follicular units, FUT maximizes the cosmetic impact of the surgery by using the full complement of 1 to 4-hairs contained in naturally occurring follicular units. A whole follicular unit will obviously contain more hair than a partial one and will give the most fullness. Keeping follicular units whole also insures maximal growth since a divided follicular unit loses its protective sheath and risks being damaged in the dissection.

It can sound impressive to claim that you performing very large hair transplants, but if the large numbers of grafts are a result dividing up follicular units, then the patient is being short-changed. The reason is that, although the number of grafts is increased, the total number of hairs transplanted is not. A 3-hair follicular unit that is split up into a 1-hair and 2-hair micro-graft will double the graft count, but not change the total number of hairs actually transplanted. In fact, due to the increased dissection, more fragile grafts, and all the other potential problems associated with very long hair transplant sessions, the total number of hairs that actually grow may be a lot less. Please look at the section “Limits to Large Hair Transplant Sessions” on the Graft Numbers page of the Bernstein Medical – Center for Hair Restoration website for a more detailed explanation of how breaking up follicular units can affect graft counts.

Donor Scarring

Since there are around 90 follicular units per cm2 in the donor scalp, one needs a 1cm wide by 28cm long (11inch) incision to harvest 2,500 follicular units. A 5,000 follicular unit procedure, using this width, would need to be 22 inches long, but the maximum length one can harvest a strip in the average individual is 13 inches (the distance around the entire scalp from one temple to the other).

In order to harvest 5,000 grafts, one would need 5,000 / 90 FU/cm2 = 55.6cm2 of donor tissue. If one takes the full 13 inch strip (33cm), then it would need to be 1.85 cm wide (55.6cm2 / (33cm long) = 1.85cm wide) or 1.85/2.54= ¾ of an inch wide along its entire length. However, one must taper the ends of a strip this wide (you can’t suture closed a rectangle) and, in addition, you can’t take such a wide strip over the ears. When you do the math again, it turns out that for most of the incision, the width must be almost an inch wide, an incredibly large amount of tissue to be removed in one procedure.

This large incision obviously increases the risk of having a wide donor scar – probably the most undesirable complication of a hair transplant. Needless to say, very large graft counts are achieved by sub-dividing follicular units rather than exposing the patient to the risk of an excessively large donor incision.

Popping

There are other issues as well. Large sessions go hand-in-hand with very high graft densities, since you often need these densities to fit the grafts in a finite area. The closer grafts are placed together, the greater the degree of popping. Popping occurs when a graft that is placed in the skin causes an adjacent one to lift-up. When a graft pops (elevates above the surface of the skin) it tends to dry out and die. Some degree of popping is a normal part of most hair transplant procedures and can be easily controlled by a skilled surgical team, but when it is excessive it can pose a significant risk to graft survival.

The best way to decrease the risk of popping being a significant problem is to not push large sessions (and the associated very dense packing) to the limit. In a patient’s first hair restoration procedure, it is literally impossible to predict the likelihood of excessive popping and once a very large strip is harvested, or the recipient sites are created in a very large session, it may be too late to correct for this. In addition, popping can vary at different times during the procedure and in different parts of the scalp adding to the problem of anticipating its occurrence.

Even if the distribution of grafts is well planned from the outset, a very large first session may force the surgeon to place hair in less-than-optimal regions of the scalp when popping occurs. This is because the surgeon must distribute the grafts further apart and thus over a larger area to prevent popping.

Blood Flow

Particularly where there is long-standing hair loss, the blood flow to the scalp has decreased making the scalp unable to support a very large number of grafts. This is not the cause of the hair loss, but the result of a decreased need for blood when the follicles have disappeared. In addition, persons that have been bald for a long time often have more sun damage on their scalp, a second factor that significantly compromises the scalp’s blood supply and may compromise the follicles survival when too many grafts are placed in one session. As with popping, the extent of photo-damage, as seen when the scalp gets a dusky-purple color during the creating of recipient sites, often only becomes evident once the procedure is well under way.

In the healing process following the first hair transplant, much of the original blood supply returns and this makes the scalp able to support additional grafts (this is particularly true if one waits a minimum of 8-10 months between procedures). This is another reason why it is better to not to be too aggressive in a first session when there is long-standing baldness or significant photo damage and where the blood supply may be compromised.

Limited Donor Supply

Another issue that is overlooked in performing a very large first session is that the average person only has about 6,000 movable follicular units in the donor area. When 5,000 grafts are used for the 1st procedure there will be little left for subsequent sessions and limit the ability of the surgeon to increase density in areas such as the frontal forelock or transplant into new areas when there is additional hair loss.

Conclusion

There are many advantages of performing large hair transplants, including having a natural look after one procedure, minimizing the number of times the donor area is accessed, and accomplishing the patient’s goals as quickly as possible. However, one should be cautious not to achieve this at the expense of a wider donor scar, poor graft growth, or a compromised ability to plan for future hair loss.

Achieving very high graft numbers should never be accomplished by dividing up the naturally occurring follicular units into smaller groups, as this increases the risk to the grafts, extends the duration of surgery, increases the cost of the procedure (when charging by the graft) and results in an overall thinner look.

For further discussion see:

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New Hair Transplant Center in NY - Bernstein Medical - Center for Hair RestorationBernstein Medical – Center for Hair Restoration has moved to a new, state-of-the-art facility in mid-town Manhattan. The office is centrally located in the Park 55 building at 110 East 55th Street.

The new office is specially engineered for performing our pioneering follicular unit hair transplant procedures and innovative corrective surgery with custom surgical suites for patient comfort and operational efficiency.

The full Bernstein Medical – Center for Hair Restoration press release is below:

State-of-the-Art Hair Transplant Facility Opens in Mid-Town Manhattan

Bernstein Medical – Center for Hair Restoration, led by pioneering hair transplant surgeon Robert M. Bernstein M.D., has completed construction of their new state-of-the-art surgical facility in midtown Manhattan.

Occupying the entire 11th floor at 110 E. 55th Street (between Park and Lexington Avenues), this sleek new office has been designed exclusively for performing Dr. Bernstein’s pioneering surgical procedure known as Follicular Unit Hair Transplantation.

The only facility in New York designed specifically for Follicular Unit Transplantation; Bernstein Medical’s new center boasts the latest techniques in hair restoration. Special features include ergonomically designed equipment used by the surgical team to make the painstakingly detailed process of stereo-microscopic dissection go smoothly and efficiently. New techniques, such as vibratory anesthesia, custom surgical chairs and special lighting, maximize patient comfort.

In his seminal publications, Dr. Bernstein introduced a novel method of hair restoration surgery which recognized follicular units (groups of naturally growing hair follicles) as the ideal way that donor tissue should be used in hair transplant procedures. FUT, as it is popularly referred to, is now considered by many to be the single most important advance in surgical hair restoration in the last decade.

On the new center Dr. Bernstein stated, “Though our previous Manhattan location and our New Jersey facility both have had the latest technologies and instrumentation, it has always been our dream to design a surgical facility that had Follicular Unit Transplantation in mind from its architectural conception.”

Working closely with his architecture and interior design team, Dr. Bernstein oversaw all aspects of the project from its inception to insure that this new environment would be one to put patients at ease. From the use of natural sunlight and soothing colors, to the shapes of glass, stone and wood, all design elements were chosen to maximize the patient experience.

Dr. Bernstein has been named for the seventh consecutive year as one of New York Magazine’s Best Doctors for his pioneering work in hair transplantation. Dr. Bernstein is known to the general public from his appearances on NBC’s Today Show with Matt Lauer, CBS’s The Early Show, ABC’s Good Morning America, The Discovery Channel and other nationally syndicated programs.

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Q: My friend just came back from Paris and said that his cousin was taking Avolve for hair loss. Can you tell me what that is and is it available in the U.S.? — N.W., Portland, Oregon

A: Avolve is the European trade name for dutasteride 0.5mg made by GlaxoSmithKline for prostate enlargement. In the U.S. dutasteride 0.5mg, under the brand name Avodart, is FDA approved to treat prostate enlargement (BPH). It has not been FDA approved for hair loss.

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Q: I had a baby 12 weeks ago and have recently been diagnosed with a hyperactive thyroid, although only slightly. I was also taking Prozac for 7-10 days. I am 27 and have been experiencing a significant amount of hair loss from all over my scalp. What are the chances that this would be permanent?

A: Based upon your history, you have three possible reasons for having a type of hair loss called telogen effluvium; thyroid disease, medication induced (Prozac) and pregnancy.

Telogen effluvium is diagnosed by a hair pull test and observing club hairs under the microscope. It is generally a reversible condition, regardless of the cause. Telogen effluvium most often occurs 2-3 months after the inducing event, so your pregnancy is the most likely cause. Prozac would less likely be the problem since you have only been on it for a short time. Besides causing Telogen effluvium, thyroid disease can also alter your hair characteristics, which can make your hair appear thinner.

Other causes of hair loss, such as genetic female pattern hair alopecia, must be ruled out. Please see the Hair Loss in Women page on the Bernstein Medical – Center for Hair Restoration website for more information.

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Q: I am considering having an FUE procedure and have heard the phrases topping, capping, and tethering as part of the procedure. What do all these terms mean? — C.C., Hell’s Kitchen, N.Y.

A: These are all terms that refer to the types of injury that can occur to grafts during a follicular unit extraction procedure.

In FUE, a sharp instrument (or sharp instrument followed by a blunt one) is used to separate follicular units from the surrounding donor tissue. Forceps are then used to remove the follicular units from the scalp.

Topping occurs in the first step when the doctor accidentally cuts off the top of the graft so that the remainder of the graft cannot be removed.

Capping occurs when the doctor grabs a graft with forceps and the top of the graft (the epidermis and upper dermis) pulls off, leaving the rest of the graft behind.

Tethering occurs when the bottom of the graft is still attached to the deeper tissues after the first step causing the follicular unit to pull apart during extraction.

There are a few other terms used as well.

Shredding occurs when the follicular unit is not totally separated from the surrounding tissue and pulls apart upon extraction. Shredding can also occur when the follicular unit was partially damaged in the first step.

Transection is like topping, but here the mid or lower portion of the hairs in the unit are cut.

Buried grafts occur when the graft is pushed into the sub-cutaneous space rather than extracted. Buried grafts can usually be removed, but if not removed completely, may turn form small cysts.

Visit the Follicular Unit Extraction page.

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Q: Dr. Bernstein, a lot of older women are taking testosterone to restore libido, but are they going to experience hair loss as a consequence?

A: They can. In women there is a delicate balance between the androgens, i.e. testosterone and estrogens. Estrogen is protective to some degree against hair loss in women, which is why most women don’t experience such severe hair loss as do men.

When a woman takes testosterone supplements it upsets that balance and can cause hair loss. However, hair loss in post-menopausal women is usually due to age related changes. Typically, the hair decreases in size in a genetically determined progression that seems not to be directly related to changes in the levels of hormones.

For more information, please see the Causes of Hair Loss in Women page on the Bernstein Medical – Center for Hair Restoration website.

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Q: I know that I am going to be bald because my father is bald and I am losing my hair just like him. What actually causes this kind of hair loss? — J.P., Paradise Valley, Arizona

A: Although there are many different causes, the overwhelming number of people that have hair loss have what is referred to as “patterned hair loss” or “androgenetic alopecia.”

In men, it is due to a hormone called DHT, which is a by-product of testosterone produced by the action of the enzyme 5-alpha reductase. This enzyme is inhibited by the hair loss medication Propecia. See the causes of hair loss in men page on the Bernstein Medical – Center for Hair Restoration website for more information.

In women, the mechanism is a little bit more complex as another enzyme, aromatase, is involved in the metabolic pathway. See the causes of hair loss in women page on the Bernstein Medical – Center for Hair Restoration website for more information.

We know that the inheritance comes from both the mother’s and father’s side, although the actual genes causing hair loss in men and women have not yet been identified. Statistically, the inheritance from the maternal side appears to be a bit stronger, but the reason for this is unknown.

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Q: I had a hair transplant of over 600 grafts using Follicular Unit Extraction (FUE) to my frontal hairline and the frontal part of my scalp. The procedure was done less than a year ago by another doctor. Since then I have had persistent pimples and redness in the area that the grafts were placed. Also, the surface of the skin in the area is irregular. — E.Z., Long Island, N.Y.

A: One of the causes of having pimples and redness following Follicular Unit Extraction may be buried hair fragments and there are significantly more hair fragments generated with the two-step FUE technique than with the three-step method.

In the three-step procedure, we use blunt dissection which minimizes transection (cutting of hair follicles) and thus reduces the incidence of hair fragments. See the Three-Step FUE page at the Bernstein Medical – Center for Hair Restoration website.

In our practice, we also place every extracted graft under the microscope. This serves a number of purposes:

  1. It gives me immediate feedback on transection rates, so that I can adjust my technique in real-time (using a stereo-microscope is much better than visual inspection for this purpose)
  2. It enables us to trim away excess tissue and hair fragments (we use the same judgment as we do with strip harvesting, so that a “viable looking” fragment would be left attached
  3. It allows us to accurately count the number of hairs in each follicular unit graft, as it is particularly important to have pure 1-hair grafts for the frontal hairline. This also allows us to better anticipate the end cosmetic result.
  4. It allows us to dissect larger follicular units into smaller ones for specific cosmetic purposes, i.e. eyebrows, hairlines, temples etc.

One of the ironies of FUE is that it is more efficient to extract the larger FUEs, since this gives us a greater hairs/hole ratio, but this often leaves us with an inadequate number of 1-hair units, which must be obtained though traditional stereo-microscopic dissection of the larger extracted grafts.

Other causes of folliculitis (manifested by pimples and redness) can result from placing the grafts too deep in the recipient site (where they may get buried) and secondary infection. A mild, transient folliculitis is often seen after a hair transplant without any precipitation factors.

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Q: I have a question about one of the products referenced under the Camouflage section of your website. As you suggested, I have begun to use DermMatch as an alternative to a hair transplant as I have diffuse thinning and been told that hair restoration is not an option right now. I have been very impressed with the results of DermMatch. However, I am concerned that the product might be damaging my existing hair or impeding future growth. Should I have any concerns about this product?

A: None of the well-known cosmetic camouflage products will damage hair or inhibit its growth.

The products come in a variety of forms, including sprays, creams, powders.

A list of these products, their descriptions, and the telephone number where you can obtain them can be found on the Cosmetic Camouflage Products page of the Bernstein Medical website.

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Hair Transplant Blog - Bernstein Medical - Center for Hair RestorationDr. Bernstein’s Hair Transplant Blog is a new medical web log (aka “blog”) that is helping the online community handle the challenges of going bald.

Selected as one of New York Magazine’s “Best Doctors” for the ninth year in a row, Dr. Bernstein answers questions at the following website URL:

www.BernsteinMedical.com/hairtransplantblog/

His replies cover over 30 categories ranging from commonly asked questions on “male pattern hair loss” and “when to have a hair transplant” to more scientific issues on specific surgical techniques.

The Hair Transplant Blog serves as a clearinghouse for important concerns of both men and women suffering from hair loss. “I consult with many patients each week in our New York and New Jersey facilities who are so distraught about the state of their hair loss that some can barely function. There is so much information available about baldness and its treatment on the internet that it is difficult to tell exactly what is true. I spend a lot of time just clarifying false, or partially correct, ideas. This misinformation just serves to exacerbate the problem.” Dr. Bernstein says “This Blog is an outgrowth of these consultations. In the Blog, I post answers to the questions that patients bring to my office or submit via our web site.”

Question are answered by Dr. Bernstein in a concise, but easy to understand way. He covers a wide variety of subjects; including new hair replacement techniques, hair transplant repair, medical therapies and interesting diagnostic problems.

The expert medical perspective in the Blog has received the attention of editors for many popular blog directories such as GetBlogs, and Answers.com. Being a featured blog has allowed people from around the world to have a better understanding of hair loss and the process of surgical hair restoration.

Dr. Bernstein has been recognized worldwide for his pioneering work in surgical hair transplantation. His landmark publications on Follicular Unit Hair Transplants, which give results that mimic nature, and Follicular Unit Extraction, a non-invasive hair replacement technique, have earned him international recognition and make him one of the foremost authorities on hair restoration in the world. Known to audiences from his appearances on NBC’s Today Show with Matt Lauer, CBS’s The Early Show, ABC’s Good Morning America, NPR’s The People’s Pharmacy, The Discovery Channel and other nationally syndicated programs, Dr. Bernstein has been providing answers and solutions for hair loss from his Manhattan facility for over 20 years.

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Q: Are camouflage agents harmful to newly transplanted follicles after a hair transplant?

A: Cosmetic camouflage products are not harmful to grafts per se, but they may make it difficult to keep the transplanted area clean right after the hair restoration procedure.

They may be used safely as early as one week following a hair transplant, since at this time they can be gently washed out without disturbing the newly transplanted grafts.

These products are useful in reducing any residual redness and can make the transplanted area appear fuller until the new grafts grow.

There are a number of products that can be used and they come in a variety of forms: creams, sprays, powders and gels. To find out where to get them, go to the Camouflage page.

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Q: Will I be unconscious during the hair transplant procedure and do you use general anesthesia? – C.L., Boston, Massachusetts

A: All of the surgical hair restoration procedures at Bernstein Medical are performed under local anesthesia. The fact that general anesthesia is not needed is what makes hair transplant procedures – even though they are long – very safe.

Patients are given a sedative to help them relax, but they are not put to sleep. Most patients watch TV, see movies or just chat during the procedure.

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Follicular Unit Forum - Bernstein Medical - Center for Hair RestorationFollicular Unit Forum is unique in that it affords visitors an opportunity to anonymously ask questions about the “ins and outs” of hair transplant surgery, of those who actually have had the state-of-the-art Follicular Unit Hair Transplant procedures.

Questions are posted to people who have actually undergone hair restoration procedures. Individuals who are considering a surgical solution to their hereditary baldness are able to search through “threads” or conversations that will answer their most pressing concerns such as; what to expect before, during and after a hair transplant, and what kind of procedure one should have.

The focus of this new online health resource is Follicular Unit Transplantation and Follicular Unit Extraction, two procedures that are universally considered to be the most up-to-date approach to surgical hair restoration. Follicular Unit Transplantation is a surgical technique that transplants hair in naturally occurring groups of 1-4 hairs. These groups (called follicular units) are taken from a single donor strip of skin and dissected using a microscope. Follicular Unit Extraction is a method that obtains the tiny follicular unit grafts from the donor area by using an instrument which removes them one-by-one directly from the scalp.

Patients who have received hair transplants with undesirable results (such as the typical pluggy “dolls hair” look) can also benefit from monitoring the site. FollicularUnitForum.com has posts from patients who have had unnatural looking grafts removed and re-implanted in a more natural way – as follicular units – to produce the most best results.

“We wanted to create a consumer-to-consumer forum that exclusively addressed the topic of Follicular Unit Hair Transplantation – the procedure that is now considered to be the gold standard in surgical hair restoration” said Robert M. Bernstein M.D., founder of Bernstein Medical – Center for Hair Restoration and sponsor of the site. “There are some great forums for hair loss out there but we felt that there was room for one that was created specifically for people who had done their preliminary research but now wanted to hear more first hand experience with FUT or FUE”.

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Q: How do you know if you have lost any grafts after a hair transplant and how long after the hair transplant can you still lose them? — T.R. Easton, Pennsylvania

A: Each day following the hair restoration, the transplanted grafts become more fixed in the scalp and the hairs in the grafts become more dissociated (loose). At nine days post-op, the grafts are fixed firmly in the scalp – it has essentially become part of the scalp in the new area and can’t be dislodged.

The hair, however, has totally separated from the follicle by this time, so that it can easily be pulled out without dislodging the remainder of the follicle that contains the growth center. When this hair is pulled out (or is naturally shed) one often sees a tiny bulb at the end. This is the root sheath of the hair and not the growth center. This is normal and is not a lost graft.

If a graft is lost, an event that may occur within the first 3-4 days following surgery, it is almost invariably associated with a small amount of bleeding.

Visit the page for Instructions After FUT Hair Transplant Surgery

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Dr. Bernstein — and a Bernstein Medical – Center for Hair Restoration hair transplant patient — were featured on NBC television’s “Today” program with Matt Lauer. The segment, which mostly covered hair transplant repair procedures and hair restoration, was one of a three-part series on hair loss.

Visit NBCNews.com for breaking news, world news, and news about the economy

Read below for a portion of the transcript:

What men will do for a few more strands of hair

Recent changes in transplant surgery have led to more natural-looking results and a boost of self confidence for some balding men

Hair transplants are one of the top five cosmetic procedures for men in the U.S., with more than 19,000 performed last year, according to the American Society for Aesthetic Plastic Surgery. But is it worth it? As part of a three-part series on hair loss, “Today” spoke with two men who underwent the procedure.

Allen Appleblatt has made a big change in his life. He works out, spends time with family and stays busy with work. And when it comes to his appearance, he’s feeling good about his new head of hair.

“I kind of felt like I was an idiot looking at myself in the mirror,” said Appleblatt. “Whenever I took a shower, at the end of the shower I found a clump of hair at the bottom of the drain. And there was no way of stopping it.”

So Appleblatt had two hair transplants. His partner, Shirley Garofano, likes what she sees.

“I liked him both ways. But I like him better now. He looks great, he’s very positive, he’s happier,” she said.

Happier, but he still wants thicker hair. “Today” followed him while he underwent his third hair transplant, taking advantage of the latest techniques.

“Over the past 10 years we’ve developed a new procedure called follicular unit transplantation, where hair is transplanted exactly the way it grows,” said Dr. Robert Bernstein, an associate clinical professor of dermatology at New York’s Columbia University.

This new technique replaces the plugs — groups of hairs inserted into round holes in the scalp — used in the early days of hair transplant procedures. It is now known that hair grows in groups of one to four hairs.

“So follicular unit transplantation is a transplantation of hair in its naturally occurring groups,” said Bernstein. “We’re really just transplanting the root.”

Appleblatt is given valium and local anesthesia, and then a donor strip is removed from the back of the head where hair is not genetically programmed to fall out.

“We have a team of people dissecting the grafts. They divide it into individual follicular units,” said Bernstein.

The units are then transplanted into the balding area. And 10 to 12 months later, the new hair will be in place.

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“Good Morning America” interviewed Dr. Bernstein in their two-part series on hair transplant surgery. View a clip of the video here:

Read the full transcript:

Charles Gibson: In a two-part series this week, “The Bald Facts,” we are looking at what works and what doesn’t in hair replacement.

And first up, we want you to meet Charles Teacher, a real estate executive who for 30 years has been a guinea pig for every kind of baldness remedy there was. Let’s look at his struggle through the years.

Charles Teacher: It was very restrictive. You’re always patting it down, looking in the mirror to see that it’s not sort of showing. It’s a really difficult way to live.

Charles Gibson: Charles Teacher should know. He’s been studying the latest trends in baldness for three decades. His hair started thinning when he was just 26, and back then he tried that bastion of hope, the comb-over.

Charles Teacher: I still had hair then. You couldn’t see that I was bald, but I could see I was very thin. It really is this fear of being unattractive to women. I suppose it is a certain amount of vanity in terms of how you look, but most of it is this fear of being rejected.

Charles Gibson: So even at an early age, he began wearing a toupee and bemoaning his genetic fate. His father had male pattern baldness. Would he spend the rest of his life worrying which way the wind blew on the golf course? Then came 1977 and the heralding of the hair plug. Charles Teacher was first in line for the surgery, and what a surgery it turned out to be.

Charles Teacher: Most of the plugs didn’t take and the few that did were in the front in a very bad hairline. It looked stupid.

Charles Gibson: This was the hairline of those old plugs, right across his forehead, so he went back to his toupee. He had a curly rug when styles were curly, a grayer one as he grayed, and he wore his hairpiece to bed. Even his wife never saw him without it.

Charles Teacher: She never saw me without the hairpiece for 30 years until I had the consultation with the surgeon who is doing the transplant and I removed it off like that.

Charles Gibson: The consultation was with hair transplant surgeon Robert Bernstein who recommended Teacher go bald, just a better bald, moving hair around to give him more on top. He demonstrated with before and after pictures of former patients. Teacher signed on and had the old plugs removed which would be added on with the rest.

Years ago in transplants like Charles Teacher’s, the surgeon removed small circles of tissue from the back of the head where hair growth is stable, then to transplant those clumps of up to 30 hairs, the surgeon would remove a matching circle of tissue from the top of the head and put in the graft. It worked, but it didn’t look natural.

Dr. Bernstein: That has always been the problem, that grafts that were done 25, 30 years ago are still around. So really the idea is not just to get the hair to grow. That’s the simple part. The challenge is to do it in a way that looks natural.

Charles Gibson: Now Charles Teacher’s best hope, single follicular unit transplants. The surgeon removes a strip of hair-producing tissue from the back of the head and separates it under a microscope into units of one to four hairs, the way hair grows naturally. The surgeon then makes tiny incisions exactly where and at what angle he wants each hair to grow and then implants it.

Teacher decided it was worth a try, even though it would cost thousands of dollars. Now he wants to burn his old toupee for one of the best results of all, to go swimming with his new grandchild, carefree.

Charles Teacher: I really feel that I’ve been given a new lease in life in many ways. It sounds silly, but just to be normal, just to be normal.

Charles Gibson: We’re joined by Charles Teacher, sans toupee, and the man who helped to get rid of it, Dr. Robert Bernstein, Associate Clinical Professor of Dermatology at Columbia University.

Good to have you both here. Why go through all this trouble? Why not just be bald?

Charles Teacher: I think it’s because I started with a hairpiece when I was rather young, 26, and I just didn’t have the guts to take it off. I think I felt a bit like Samson and Delilah, should we say, you know, if I lost my hair, I’d lose my strength or my personality.

Charles Gibson: And you’re pleased with this.

Charles Teacher: It’s just awesome.

Charles Gibson: Dr. Bernstein, is his hair actually growing? I had always heard that you can transplant hair, but you can’t make it grow.

Dr. Bernstein: No, actually, a transplant will continue to grow. He has to get haircuts just like it’s his normal hair.

Charles Gibson: Are there good candidates and bad candidates for this?

Dr. Bernstein: Yes. And actually people that wear hairpieces are sometimes tricky because their baseline is a full head of hair, so one of the important things that we had to discuss in the first consult was what his expectations were and whether he realized that a transplant wouldn’t give him the fullness of a hairpiece, but of course, it would look much more natural.

Charles Gibson: That’s why you lose the line, you’re still bald to some extent, but it’s a better kind of bald.

Dr. Bernstein: Yes.

Charles Gibson: Single follicular unit transplants is such a mouthful, but basically it’s saying you’re just transplanting a hair two or three at a time.

Dr. Bernstein: Right. In the old days, hair was planted in little clumps and then it was divided into small pieces but arbitrarily. Now we transplant hair exactly the way it grows in nature, and hair normally grows in little tiny bundles and they’re called follicular units.

Charles Gibson: I don’t know if it’s dirty trick, but we have a camera behind you because in the back of your head, you’re going to have a second procedure now.

Charles Teacher: Yes, we’ll have a second procedure actually this morning. I think that we’ll leave the back and probably just reinforce the front so that it –- I mean, you don’t really see the back of your head, you’re only worried about how you appear in the mirror.

Charles Gibson: Right. How much does it cost?

Charles Teacher: I haven’t told my wife. Can I give that a miss?

Charles Gibson: Well, I’m sure Dr. Bernstein, he’ll probably say something.

Dr. Bernstein: We charge about $5 a graft.

Charles Gibson: About $5 a graft, which is one, two, three, four, five hairs –-

Dr. Bernstein: That’s right.

Charles Gibson: — per time. So that gets rather expensive. I mean, we’re talking about $10,000, $15,000 for a total procedure?

Dr. Bernstein: Yes.

Charles Gibson: Which insurance does or does not cover?

Dr. Bernstein: It usually does not.

Charles Gibson: But you probably spent that much in toupees over the time.

Charles Teacher: Absolutely. You know, so $2,000 or $3,000 a year with the toupees and the hairdresser worrying every week, you know, yeah.

Charles Gibson: Gotta ask. You’re a little thin on top yourself, yet you haven’t done this.

Dr. Bernstein: Everybody asks me that. It just doesn’t bother me. And I think it’s important being a doctor that people, when they come to see me, they don’t feel compelled that they have to have the transplant, that they’re here because they want to. And that being bald is okay.

Charles Gibson: So the title, if somebody’s interested in this, is follicular unit transplant.

Dr. Bernstein: Yes.

Charles Gibson: All right. Dr. Bernstein, thanks very much. Charles Teacher, thank you very much.

Charles Teacher: Thank you.

Charles Gibson: Good to see you. Good luck with the procedure today.

Charles Teacher: Thank you.

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